Name

Birth date

Gender

Department

Application Number

state

Nationality IndianOther

Religion

Commmunity

Caste

Communication Address

Permenant Address

E-Mail ID

Landline Number With STD Code

Mobile Number

10th Mark

12th Mark

Mathematics (out 0f 200)

Physics (Out Of 200)

Chemistry (Out of 200)

Medium of Studied

Name of the Institute last studied

Head of Institute

Institute Address

Institute Phone Number

Father's Name

Father's Occupation

Father's Working Address

Father's Mobile Number

Mother's Name

Mother's Occupation

Mother's Working Address

Mother's Mobile No

Family Member Name

Relationship

Qualification